Eletriptan is a selective, high affinity serotonin 5-HT(1B/1D)-receptor agonist which is rapidly absorbed and has a long half-life in plasma. Eletriptan has been shown to be effective and well tolerated in randomised, double-blind, placebo-controlled acute migraine trials and long-term open-label trials. Eletriptan maintains a consistency of response across three attacks and patients continue to respond to eletriptan for at least up to 1 year. Eletriptan has been compared with sumatriptan, zolmitriptan, naratriptan and ergotamine/caffeine in placebo-controlled, randomised, head-to-head trials, and has shown better efficacy with similar adverse events. In a large triptan meta-analysis, including 53 trials and > 24,000 patients, eletriptan 80 mg showed better efficacy, similar consistency but lower tolerability compared with sumatriptan 100 mg. Eletriptan has also shown efficacy in difficult-to-treat patients who were dissatisfied with their previous treatment with sumatriptan, rizatriptan, nonsteroidal anti-inflammatory drugs or Excedrin.